Transmission and Prevention of HIV

Return to: Get the Facts

  1. A person cannot become infected with HIV through casual contact (e.g., shaking hands, hugging, kissing, eating off the same plate, sitting on the same toilet seat, etc.). It is also impossible to become infected by donating blood, as sterile needles are used to draw blood from a single donor and are then thrown away.
  2. HIV can only be transmitted through four specific bodily fluids: blood, semen, vaginal secretions and breast milk.
  3. Because HIV is transmitted only through these four fluids, one can become infected with HIV in only three specific, preventable ways:
    1. Mother to child: The transmission of the virus from mother to child can occur in utero during the last weeks of pregnancy and during labor and delivery. A child born to an HIV-positive mother will test positive for HIV antibodies at birth, as babies are born with their mother’s immune system antibodies. Within 18 months, however, the child will develop his/her own immune system and antibodies. In the absence of treatment, the child has a 25% chance of being HIV-positive at the end of this 18-month period. But a pregnant woman who knows she is HIV-positive can now take preventative measures—including antiretroviral therapy and giving birth by caesarean section—that can reduce the rate of transmission to 1%. (The likelihood correlates to the mother’s viral load.) Breastfeeding increases the risk of transmission by about 4%.
    2. Sharing needles or other paraphernalia for intravenous (IV) drug use, piercing or tattooing: The sharing of needles or other paraphernalia can transmit HIV, as blood can be carried from one user to another. It is important to recognize that IV drugs include not only hard drugs such as heroin, cocaine and crystal methamphetamine, but also steroids, insulin and anything else injected with a needle.
    3. Oral, anal and vaginal sex: All three practices are very risky without protection. There is no such thing as safe sex (except abstinence, postponing sex, masturbation or mutual masturbation). Instead, we call it safer sex.
      1. Abstaining from or postponing sex is the safest “sex”—an option that should be seriously considered. Postponing sex does not mean never having sex; instead, it means choosing to wait until a later time in life to have sex. People choose to postpone sex for a variety of reasons, such as: preferring to wait until one is ready for sex; wanting to wait for the right person to have sex with; not being comfortable discussing these issues with one’s current partner; not having enough information; or not having condoms available in order to practice safer sex.
      2. The only way to prevent the transmission of HIV through oral, vaginal or anal sex is by using a latex or polyurethane barrier such as a male or female condom. This prevents the exchange of bodily fluids such as blood, semen, preseminal fluid (the fluid that appears at the tip of the penis prior to ejaculation, also known as precum) and vaginal fluids, all of which can transmit HIV from an infected person.
        Safer sex: A latex or polyurethane male or female condom put on before genital contact and taken off only after ejaculation is the safest kind of sex. This applies to oral, vaginal and anal sex. Condoms come in a wide variety of brands, types, sizes and styles. It is important to check the expiration date on the condom package to make sure it has not passed and to find a condom that works for you. A condom must be held by its tip while it is rolled down over the penis, fitting snugly all the way from the head to the base of the penis. Only water-based lubricant can be used with a condom, since oil-based lubricants erode latex.
        When used consistently (every time) and correctly, condoms are 97% effective. Get instructions on proper storage and use of condoms.
        Condom failure is usually the result of improper use. Some common errors include:

        • Beginning intercourse without a condom, with the intention of putting one on later.
        • Taking the condom off in the middle of intercourse.
        • Putting the condom on incorrectly—for example, inside-out or not rolled all the way down over the penis.
        • Using a condom that does not fit properly (although most condoms fit most men).
        • Accidentally tearing or puncturing the condom while putting it on, during sex, or while removing the penis after ejaculation. (Watch for sharp nails or jewelry and never use teeth to open the condom package.)
        • Using an oil-based lubricant with the condom. (Oil degrades the latex and may cause holes.)
        • Using a lambskin (or “natural skin”) condom. (While these condoms do prevent pregnancy, they are not effective at preventing the transmission of HIV.)
        • Using a condom with an expiration date that has passed. (Expiration dates are normally printed on the condom box or wrapper.)

        A latex barrier (such as a dental dam or cut-open condom) must be used as a barrier between partners when mouth-to-vagina or mouth-to-anus oral sex is performed. HIV can be found in the vaginal fluid of infected women and in blood introduced through tears in the lining of the anus.

      3. Negotiating safer sex with partners is an essential skill. It may help to view practicing safer sex as a sign of respect—for both yourself and your partner. In addition, safer sex is sexy. By being honest and protecting yourselves, you and your partner can concentrate on each other and the experience, not the potential consequences.
      4. There are many myths about the transmission of HIV. Douching after intercourse, practicing withdrawal (pulling out before ejaculation), or using birth control methods other than condoms (e.g., the pill, Depo Provera—”the shot”, an intrauterine device—IUD, or a diaphragm) does not prevent the spread of HIV. The only way to prevent the transmission of HIV through oral, vaginal or anal sex is by using a latex or polyurethane barrier such as a male or female condom.
      5. Drugs and alcohol play a significant role in the transmission of HIV.
        The use of drugs and alcohol lowers inhibitions, impairs judgment and makes it harder to resist the temptation to have sex or to insist upon safer sex. It is important to keep condoms and water-based lubricant available if there is any possibility that you may be engaging in sexual activity. Condoms can be bought at stores and are available through many health clinics. In addition, many high schools and some middle schools have condom availability programs.

        Drugs, when taken intravenously, can be directly responsible for transmitting HIV if needles are shared and not cleaned properly.

      6. There is a strong correlation between HIV and other sexually transmitted diseases (STDs), which are also referred to as sexually transmitted infections (STIs). That’s why it is essential that anyone who is sexually active get tested regularly—and receive treatment if necessary—for STDs/STIs.
      7. If you suspect that you may have been exposed to HIV, there is a treatment that may reduce your risk of contracting HIV. To obtain this treatment, known as post-exposure prophylaxis (PEP), you must visit a doctor as soon as possible and no later than 36 hours after exposure.

I learned to be a listener more. When my grandchild starts asking about sex or wants to talk about it, I will listen first before I speak.

– Parent Workshop Participant

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